IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v19y2018i9d10.1007_s10198-018-0970-6.html
   My bibliography  Save this article

Impact of increasing treatment rates on cost-effectiveness of subcutaneous immunotherapy (SCIT) in respiratory allergy: a decision analytic modelling approach

Author

Listed:
  • Ann-Kathrin Richter

    (Institute for Health Care Management and Research, University of Duisburg-Essen)

  • Ludger Klimek

    (Centre for Rhinology and Allergology)

  • Hans F. Merk

    (University Clinic RWTH)

  • Norbert Mülleneisen

    (Asthma and Allergy Centre)

  • Harald Renz

    (Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University)

  • Wolfgang Wehrmann

    (Dr. Rödder-Wehrmann and colleagues)

  • Thomas Werfel

    (Hannover Medical School)

  • Eckard Hamelmann

    (Children’s Center Bethel, Protestant Hospital Bielefeld and Allergy Center Ruhr-University)

  • Uwe Siebert

    (UMIT-University for Health Sciences, Medical Informatics and Technology
    MGH-ITA
    Harvard T.H. Chan School of Public Health)

  • Gaby Sroczynski

    (UMIT-University for Health Sciences, Medical Informatics and Technology)

  • Jürgen Wasem

    (Institute for Health Care Management and Research, University of Duisburg-Essen)

  • Janine Biermann-Stallwitz

    (Institute for Health Care Management and Research, University of Duisburg-Essen)

Abstract

Background Specific immunotherapy is the only causal treatment in respiratory allergy. Due to high treatment cost and possible severe side effects subcutaneous immunotherapy (SCIT) is not indicated in all patients. Nevertheless, reported treatment rates seem to be low. This study aims to analyze the effects of increasing treatment rates of SCIT in respiratory allergy in terms of costs and quality-adjusted life years (QALYs). Methods A state-transition Markov model simulates the course of disease of patients with allergic rhinitis, allergic asthma and both diseases over 10 years including a symptom-free state and death. Treatment comprises symptomatic pharmacotherapy alone or combined with SCIT. The model compares two strategies of increased and status quo treatment rates. Transition probabilities are based on routine data. Costs are calculated from the societal perspective applying German unit costs to literature-derived resource consumption. QALYs are determined by translating the mean change in non-preference-based quality of life scores to a change in utility. Key parameters are subjected to deterministic sensitivity analyses. Results Increasing treatment rates is a cost-effective strategy with an incremental cost-effectiveness ratio (ICER) of 3484€/QALY compared to the status quo. The most influential parameters are SCIT discontinuation rates, treatment effects on the transition probabilities and cost of SCIT. Across all parameter variations, the best case leads to dominance of increased treatment rates while the worst case ICER is 34,315€/QALY. Excluding indirect cost leads to a twofold increase in the ICER. Conclusions Measures to increase SCIT initiation rates should be implemented and also address improving adherence.

Suggested Citation

  • Ann-Kathrin Richter & Ludger Klimek & Hans F. Merk & Norbert Mülleneisen & Harald Renz & Wolfgang Wehrmann & Thomas Werfel & Eckard Hamelmann & Uwe Siebert & Gaby Sroczynski & Jürgen Wasem & Janine Bi, 2018. "Impact of increasing treatment rates on cost-effectiveness of subcutaneous immunotherapy (SCIT) in respiratory allergy: a decision analytic modelling approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(9), pages 1229-1242, December.
  • Handle: RePEc:spr:eujhec:v:19:y:2018:i:9:d:10.1007_s10198-018-0970-6
    DOI: 10.1007/s10198-018-0970-6
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-018-0970-6
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s10198-018-0970-6?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Jeff Richardson & Munir A. Khan & Angelo Iezzi & Aimee Maxwell, 2015. "Comparing and Explaining Differences in the Magnitude, Content, and Sensitivity of Utilities Predicted by the EQ-5D, SF-6D, HUI 3, 15D, QWB, and AQoL-8D Multiattribute Utility Instruments," Medical Decision Making, , vol. 35(3), pages 276-291, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tom Lung & Kirsten Howard & Christopher Etherton-Beer & Moira Sim & Gill Lewin & Glenn Arendts, 2017. "Comparison of the HUI3 and the EQ-5D-3L in a nursing home setting," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-10, February.
    2. Bruno Casal & Eva Rodríguez-Míguez & Berta Rivera, 2020. "Measuring intangible cost-of-morbidity due to substance dependence: implications of using alternative preference-based instruments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(7), pages 1039-1048, September.
    3. Christian R. C. Kouakou & Thomas G. Poder, 2022. "Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 277-299, March.
    4. Michael J. Zoratti & A. Simon Pickard & Peep F. M. Stalmeier & Daniel Ollendorf & Andrew Lloyd & Kelvin K W Chan & Don Husereau & John E. Brazier & Murray Krahn & Mitchell Levine & Lehana Thabane & Fe, 2021. "Evaluating the conduct and application of health utility studies: a review of critical appraisal tools and reporting checklists," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 723-733, July.
    5. Suzi Claflin & Julie A. Campbell & Richard Norman & Deborah F. Mason & Tomas Kalincik & Steve Simpson-Yap & Helmut Butzkueven & William M. Carroll & Andrew J. Palmer & C. Leigh Blizzard & Ingrid van d, 2023. "Using the EQ-5D-5L to investigate quality-of-life impacts of disease-modifying therapy policies for people with multiple sclerosis (MS) in New Zealand," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(6), pages 939-950, August.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:19:y:2018:i:9:d:10.1007_s10198-018-0970-6. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.